Thinking of having LASIK?

Hey Lilou,

A few weeks ago I discussed the concerns with my brother about getting the operation done and he said he would give it more thought before going ahead with it. His girlfriend has two close friends whom he has spoken with that both had the operation done and they are extremely happy with the results. No dry eyes, no halos and clear sight so far. They are all from Columbia and this would be the same doctor doing the operation on him. He ended up telling me that he would decide when he consults with the doctor. I know that doesn't mean much because the doctors still gonna try to make the sale but free will and all says I've done all I can do.

Just heard from my brother last night during the supermoon. He's in Columbia with his girlfriend and just had the operation done. He says after a few tests the doctor explained to him that in 4 or 5 years he would probably need reading glasses but that's about it. My brother did also say that his prescription for his contacts has only changed a small percentage in the past 5 years so apparently his eyesight isn't that bad after all. He must have felt good about doing it because before he left he said if there is just one hesitation from the doctor in any way for any reason that he would just call it a day and forget it, but he didn't. He said the operation took about ten minutes and instantly he was seeing clearly. He just has to follow the precautionary measures for the next month or so but he should be okay.

I do appreciate all your info and help and I did make it a point to show it all to him but in the end only he can decide and now all I can do is wish the best for him.

Thanks again Lilou
 
I'm happy your brother had a good outcome, Pete. It sounds like the surgeon is very good and the long term results are usually better if the perscription is steady for many years.

You really have to choose surgeons carefully, especially at the Lasik clinics, owned by multinational corporations. I remember a few years ago, a clinic in Indianapolis, used to fly Lasik surgeons in for the day. It is good pay, something along the order of $15,000/day! But they would stack the patients up, as many as they could, often more than the schedule allowed. My partner, who was being wooed to work at this clinic, was so pissed off, he just told them forget it, because they had that surgeon working until 1 am next morning!! The staff was exhausted, but it was end of the quarter and they needed so many patients, so management would get their bonus. Sick! So $$ always wins over ethics in these corporations.

Moral, always make your doctor's appointments early in the day, preferraby morning, as we're not the sharpest knifes in the drawer by late afternoon! :P
 
Lilou said:
I haven't seen any patients on follow up for this procedure, but there is also Conductive Keratoplasty, CK for short. Here's a link that explains the procedure _http://www.usaeyes.org/lasik/faq/lighttouch-nearvision-ck.htm I haven't researched it much, but the doctor I used to work for does this procedure. I went to a continuuing ed class about it, but I fell asleep! :-[

How bout just getting an eye exam, Rabelais?? You may need just a little bit of magnification for distance, and a bit more on top of that for reading. A nice fashionable pair of no line, progressive trifocals sounds better to me than surgery!! I often see alittle astigmatism on folks needing readers. It's kind of like water running over a rock, the mechanical action of the eyelid passing over the cornea for years and years, changes the shape of the cornea - causing some astigmatism (cornea no longer round).

But I'd try the glasses first. :cool:

Yeah, I have found an optometrist that all of my older Brit friends are raving about (probably because he speaks English :/)
It is time to go. I am seeing a slight double image when I look at the moon or other light source after dark. I thought the effect was from looking through the double glazed windows, but nooo. Wishful thinking. Its just as bad outside.

My right eye is not nearly as good with the readers anymore. My cornea on the right is probably no longer round. My old prescription trifocals from the states are still good for driving, and I really need them for that these days. Keith and Mick nailed it "What a drag it is getting old..."
 
Rabelais said:
Yeah, I have found an optometrist that all of my older Brit friends are raving about (probably because he speaks English :/)
It is time to go.

Yep, go get an exam. Even in the small village of Moissac, there was an optical on every corner! No shortage of choices, for sure. But I'd say the doc that speaks English would be a definite plus!

And the Rolling Stones are right....it is a drag getting old! :cool2:
 
Lilou of all LASIK complications you encountered in your practice have you ever seen severe chronic dry eyes to the point of disability?
Apparently few people committed suicide because of this.
 
H.E. said:
Lilou of all LASIK complications you encountered in your practice have you ever seen severe chronic dry eyes to the point of disability?
Apparently few people committed suicide because of this.

I have personally not seen any cases of dry eye, bad enough that the patient would want to kill themselves or would be disabled. I generally only see about 3-5 post lasik patients per month. Most have said the dry eye symptoms abated after a few months. There was one lawsuit that I am aware of - the patient sued the optometrist for not informing them of the possiblility of severe dry eye. The case was settled, the patient won a tidy sum of money.

Most of my patients also say that the difficulty night driving (glare and halos) gets better over time (3-6 months) but never totally disappears. And all say driving at night in the rain is very difficult.
 
Well I did a lot of research and it seems that halos and similar complications are now thing of the past with the new generation of laser machines.
My main concern was severe dry eye as I found some horror stories on the net, these do come exclusively from USA.
The clinic I chose emphasizes detailed pre-operative exam on which the suitability for the surgery is based.
The surgeon was very forthcoming with all my queries and said that they did 1000 surgeries in last 2 years and they never had one case of severe dry eyes. This would be less then 0.1% which is far cry from 20% which FDA claims. The same FDA official who had LASIK endorsed in USA is now on the crusade against it and the whole thing seems a bit fishy.

In any case I am pretty much decided but we will see what will be the results of their detailed exam of my eyes, corneal thickness and tear film.

They use this technology __http://www.alconsurgical.com/ISI_Refractive-Lasers.aspx
 
They say following on their website:

Pupil sizes should be evaluated under mesopic illumination conditions. Effects of treatment on vision under poor illumination cannot be predicted prior to surgery. Some patients may find it more difficult to see in such conditions as very dim light, rain, fog, snow and glare from bright lights. This has been shown to occur more frequently in the presence of residual refractive error and perhaps in patients with pupil sizes larger than the optical zone size.

The refraction is determined in the spectacle plane, but treated in the corneal plane. In order to determine the right treatment program to achieve the right correction, assessment of the vertex distance during refraction testing is recommended. Preoperative evaluation for dry eyes should be performed. Patients should be advised of the potential for dry eyes post LASIK and post wavefront-guided LASIK surgery. This treatment can only be provided by a licensed healthcare professional.

Adverse Events and Complications for Myopia: Certain adverse events and complications occurred after the LASIK surgery. Two adverse events occurred during the postoperative period of the clinical study: 0.2% (2/876) had a lost, misplaced, or misaligned flap reported at the 1 month examination.

The following adverse events did NOT occur: corneal infiltrate or ulcer requiring treatment, corneal edema at 1 month or later visible in the slit lamp exam; any complication leading to intraocular surgery; melting of the flap of >1 mm2; epithelium of >1 mm2 in the interface with loss of 2 lines or more of BSCVA; uncontrolled IOP rise with increase of >5 mmHg or any reading above 25 mmHg; retinal detachment or retinal vascular accident; and decrease in BSCVA of >10 letters not due to irregular astigmatism as shown by hard contact lens refraction.

The following complications occurred 3 months after LASIK during this clinical trial: 0.8% (7/844) of eyes had a corneal epithelial defect; 0.1% (1/844) had any epithelium in the interface; 0.1% (1/844) had foreign body sensation; 0.2% (2/844) had pain; and 0.7% (6/844) had ghosting or double images in the operative eye.

The following complications did NOT occur 3 months following LASIK in this clinical trial: corneal edema and need for lifting and/or reseating the flap/cap.

Adverse Events and Complications for Hyperopia: Certain adverse events and complications occurred after the LASIK surgery. Only one adverse event occurred during the clinical study: one eye (0.4%) had a retinal detachment or retinal vascular accident reported at the 3 month examination.

The following adverse events did NOT occur: corneal infiltrate or ulcer requiring treatment; lost, misplaced, or misaligned flap, or any flap/cap problems requiring surgical intervention beyond 1 month; corneal edema at 1 month or later visible in the slit lamp exam; any complication leading to intraocular surgery; melting of the flap of > 1 mm2; epithelium of > 1 mm2 in the interface with loss of 2 lines or more of BSCVA; uncontrolled IOP rise with increase of > 5 mmHg or any reading above 25 mmHg and decrease in BSCVA of > 10 letters not due to irregular astigmatism as shown by hard contact lens refraction.

The following complications occurred 6 months after LASIK during this clinical trial: 0.8% (2/262) of eyes had a corneal epithelial defect and 0.8% (2/262) had any epithelium in the interface.

The following complications did NOT occur 6 months following LASIK in this clinical trial: corneal edema; foreign body sensation; pain, ghosting or double images; and need for lifting and/or reseating of the flap/cap.

Adverse Events and Complications for Mixed Astigmatism: Certain adverse events and complications occurred after the LASIK surgery. No protocol defined adverse events occurred during the clinical study. However, two events occurred which were reported to the FDA as Adverse Events.

The first event involved a patient who postoperatively was subject to blunt trauma to the treatment eye
6 days after surgery. The patient was found to have an intact globe with no rupture, inflammation or any dislodgement of the flap. The second event involved the treatment of an incorrect axis of astigmatism which required retreatment.

The following adverse events did NOT occur: corneal infiltrate or ulcer requiring treatment; corneal epithelial defect involving the keratectomy at 1 month or later; corneal edema at 1 month or later visible in the slit lamp exam; epithelium of > 1 mm2 in the interface with loss of 2 lines or more of BSCVA; lost, misplaced, or misaligned flap, or any flap/cap problems requiring surgical intervention beyond 1 month; decrease in BSCVA of > 10 letters not due to irregular astigmatism as shown by hard contact lens refraction; any complication leading to intraocular surgery; melting of the flap of > 1 mm2; uncontrolled IOP rise and retinal detachment or retinal vascular accident.

None of the following complications occurred at 3 months after LASIK during this clinical trial: corneal edema; corneal epithelial defect; any epithelium in the interface; foreign body sensation, pain, ghosting or double images; and need for lifting and/or reseating of the flap/cap.

Subjects were asked to complete a patient questionnaire preoperatively and at 3-months, 6-months, and
1-year postoperatively.

Adverse Events and Complications for Wavefront - guided Myopia: Certain adverse events and complications occurred after the wavefront-guided LASIK surgery. No adverse event occurred during
wavefront-guided treatments during this clinical study.

The following adverse events did NOT occur: corneal infiltrate or ulcer requiring treatment; lost, misplaced or misaligned flap or any flap/cap problems requiring surgical intervention beyond 1 month; corneal edema at 1 month or later visible in the slit lamp exam; any complication leading to intraocular surgery; melting of the flap of > 1 mm2; epithelium of > 1 mm2 in the interface with loss of 2 lines or more of BSCVA; uncontrolled IOP rise with increase of > 5 mmHg or any reading above 25 mmHg; and decrease in BSCVA of > 10 letters not due to irregular astigmatism as shown by hard contact lens refraction.

The following complications occurred 3 months after wavefront-guided LASIK during this clinical trial: corneal epithelial defect (0.6%); foreign body sensation (0.6%); and pain (0.6%).

The following complications did NOT occur 3 months following wavefront-guided LASIK in this clinical trial: corneal edema; any epithelium in the interface; ghosting or double images; and need for lifting and/or reseating of the flap/cap.

ATTENTION: The safety and effectiveness of LASIK surgery has ONLY been established with an optical zone of 6.0 – 6.5 mm and an ablation zone of 9.0 mm.
 
Just wanted to add that I have encountered great number of anti-lasik websites that seem very dodgy to say the least. Could it be - optical industry has declared war on LASIK?

For example this site here has the forum with personal testimonies of "victims" and most of these sound very strange. I immediately became suspicious when I read the account of someone who had the surgery, never had any complications but still advocates against it?!
_http://visionsurgeryrehab.evecommunity.com/eve/forums/a/frm/f/6541031211

I am aware that I am to certain extent invested in the idea of having surgery and therefore biased and I would really value some objective input.
 
H.E. said:
I am aware that I am to certain extent invested in the idea of having surgery and therefore biased and I would really value some objective input.

It's pretty obvious that you're invested in this idea. You've basically already made the decision and are now looking for confirmation of it. As I said earlier in this thread, there's no way I'd have LASIK surgery (and my vision is really bad) - any risk at all that something could go wrong, or just "not right" is too high a risk when it comes to my eyes.

So, if you're looking to feel better about this decision, I'm not sure you're going to get that here - but - it's your decision to make and I hope it goes well for you.
 
Thank you Anart.
Well I haven't made the decision yet. I have only made the appointment for the examination which I will stick to as I haven't done such detailed eye exam in a while or maybe never as they seem to use latest technology. So even if I dont go for surgery it will not be a waste of money.

This is certainly a tough one and I find myself fluctuating from YES to NO depending what is the latest thing I read. I know nobody can make me feel better about this decision - I also know that whatever I decide I will have to live with it till the rest of my life.

Its a veritable conundrum- I cannot wear glasses all the time as they are pretty restrictive, and during the night they give me very weird feeling, lenses are mostly fine but there are hard moments and at least once a year I get pretty bad conjunctivitis.
It would be much easier if this was problem that was endangering my life - then I would take the risk without think twice about it.
This has potential to increase quality of my life significantly hence the attraction , but then it also has potential of doing the exact opposite. Perhaps its time to stop over thinking and meditate on it.
 
I personally have never wanted to go for it nor do I want to today. I have very bad eyes (myopia) and I think I'm up to roughly -5.0 in both eyes. If I take off my glasses I can't even read the computer screen. I can only see perfectly clear from about 7 inches and less away from a target.

Anyhow, point is I find it absolutely not worth the risks, no matter how small they can be. But there is also the fact that it's not something that bothers me. It's not like I wake up in the morning and think "ahh darn glasses, when will this torture cease" if you catch my drift. I've just became so used to it that I don't even think about it anymore. It's how I am and I fully accept it.

My thoughts.

Peace.
 
JayMark said:
I personally have never wanted to go for it nor do I want to today. I have very bad eyes (myopia) and I think I'm up to roughly -5.0 in both eyes. If I take off my glasses I can't even read the computer screen. I can only see perfectly clear from about 7 inches and less away from a target.

Anyhow, point is I find it absolutely not worth the risks, no matter how small they can be. But there is also the fact that it's not something that bothers me. It's not like I wake up in the morning and think "ahh darn glasses, when will this torture cease" if you catch my drift. I've just became so used to it that I don't even think about it anymore. It's how I am and I fully accept it.

My thoughts exactly. I also have very poor eyesight, but for me the bottom line is that glasses and contact lenses do enable me to see properly and even though yes at times they can be inconvenient, to me inconvenience is not a great enough problem to take the risk of permanently damaging my eyes.

my two cents
 
I was born severely nearsighted and wore Coke-bottle thick lenses all through my childhood into my 30s. I had such a complex about them from years of ridicule that in my mid 30s I underwent radial keratotomy, which was the cornea surgery offered pre-LASIK and done by hand. :scared:

Long story short, my astigmatism and myopia were too severe for the surgery but the doctor didn't tell me that. I still wear glasses, although now they are much thinner. My vision fluccuates the entire day, and it's impossible to get an accurate eye glass prescription. My night vision has been destroyed so that I see halos, starbursts, and shadows, which make it practically impossible to drive after sunset.

So, while I understand the desire to be free of glasses, if one can wear contacts comfortably (I could not, dry eyes), then no way in you-know-where would I ever have any surgery on my eyes again.
 
Thank you for posting this Lilou!

As another of many with corrective glasses and contacts, I've let a ew thoughts wander this way a time or two before. I've always been skeptical and honestly, the only first-person source I know who's had this done has had great results! Still I've always been more than a little skeptical! Turns out it was for good reason!

Thanks again! Much gratitude!
 
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